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Clin Transplant . COVID-19 in heart transplant recipients during February - August 2020: A systematic review

tetano

Editor, Senior Moderator
Clin Transplant


. 2021 Jun 22.
doi: 10.1111/ctr.14390. Online ahead of print.
COVID-19 in heart transplant recipients during February - August 2020: A systematic review


Carlos Diaz-Arocutipa[SUP] 1 2 3 [/SUP], Darla Carvallo-Castañeda[SUP] 3 4 [/SUP], Odalis Luis-Ybañez[SUP] 3 5 [/SUP], Marcos Pariona[SUP] 6 [/SUP], Mercedes Rivas-Lasarte[SUP] 7 8 [/SUP], Jesús Álvarez-García[SUP] 8 9 10 [/SUP]



Affiliations

Abstract

The coronavirus disease 2019 (COVID-19) pandemic represents a major concern in immunosuppressed patients such as heart transplant recipients. Therefore, we performed a systematic review to summarize the clinical features, treatment, and outcomes of heart transplant recipients with COVID-19. We searched electronic databases from inception to January 11, 2021. Thirty-nine articles (22 case reports and 17 cohorts) involving 415 patients were included. The mean age was 59.9 ± 15.7 years and 77% of patients were men. In cohort studies including outpatients and inpatients, the hospitalization rate was 77%. The most common symptoms were fever (70%) and cough (67%). Inflammatory biomarkers (C-reactive protein and procalcitonin) were above the normal range. Forty-eight percent of patients presented with severe or critical COVID-19. Hydroxychloroquine (54%), azithromycin (14%), and lopinavir/ritonavir (14%) were the most commonly used drugs. Forty-nine percent of patients discontinued the baseline regimen of antimetabolites. In contrast, 59% and 73% continued the same regimen of calcineurin inhibitors and corticosteroids, respectively. Short-term mortality among cohorts limited to inpatients was 25%. Our review suggests that heart transplant recipients with COVID-19 exhibited similar demographic and clinical features to the general population. However, the prognosis was poor in these patients. This article is protected by copyright. All rights reserved.

Keywords: COVID-19; heart transplantation; systematic review.
 
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